| NPI | 1235380429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A108891) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A108891) | |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2011-07-08 |